Guided Pelvic Resections in Tumor Surgery

Abstract

Primary bone sarcoma of the pelvis is one of the more challenging pathologies treated by orthopedic oncologists. In particular, their anatomic complexity contributes to delays in diagnosis and high rates of positive margins with associated high rates of local recurrence, all contributing to poor outcomes in this patient population. Computer-assisted surgery in the form of navigation and patient-specific instrumentation has shown promise in other fields of orthopedics. Intuitively, in an effort to improve tumor resections and improve oncologic outcomes, surgeons have been working to apply these advances to orthopedic oncology. Early studies have demonstrated benefits from guided pelvic resections, with studies demonstrating improved resection accuracy, fewer positive margins and decreased rates of local recurrence. Although these techniques are promising and will likely become an essential tool for orthopedic oncologist, surgeons must understand the limitations and costs associated with each technology before blind adoption.